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Radiographic examination:

case presentation

during initial visit R.g examination including:

-panoramic X-ray that revealed close proximity of sinus floor to alvealar ridge

-also the dental arch shows, irregular amount of bone resorption especially in premolar and molar region in upper arch.

Dentally :

maxillary arch:

-missing 7 6 4 2 1 , 1 2 5 6 7

treatment plane

-the RT side of upper region area revealed moderate amount of bone resorption.

- |_ 3 : shows root caries.

mandibular arch:

-missing 6 5 3 2 1 , 1 2 3 4 7

periapical X-ray must done to confirm the diagnosis

especially on:

|3 : shows root caries

| 5 : shows failed endodontic treatment

partial over denture

-RT side of lower region area revealed good amount of bone.

7 :class I, amalgam restoration

-left side of lower region area shows "irregular bone resorption"

5 : endo TTT tooth

6 : class I amalgam

This case need full mouth rehabilitation

over denture:

definition

derive support from one or more abutment by complete enclosing them beneath its fitting surface

checking the mobility, furcation involvement & periodontal health state of the teeth.

Scalling ,root planning & oral hygiene instruction must done to improve the oral hygiene of the Patient . then, Reschadual after two weeks to check the prognosis of the healing.

advantage

Extraoral examination:

1- support

2-{preservation of alveolar bone}

3- retention

4-stability

5-{increase mastication force}

6-improve C\R ratio

7- decrease damaging lateral forces

History:

collapse extraoral facial profile

Intraoral examination:

A 65years-old male patient

pt have missing teeth and unable to masticate

complaint:

disadvantage:

presence partially edentulous upper & lower arches, with moderately resorbed maxillary arch in premolar & molar regions, the patient have moderate oral hygiene.

The state of the teeth in the upper arch shows:

medical& hematological examination:

1-need RCT

2-need maintenance from patient and dentist

5 : shows amount of gingival recession.

-pt reported an acute attack of sinusitis about 2 weeks prior to the first appointment

indication

The state of the teeth in lower arch shows:

-No absolute contraindication to any therapeutic or surgical modality. also, pt unwillingness for invasive surgical procedures.

Dental hitory:

1- motivated patient + good oral hygiene

2- sever tooth wear

3-Hypodontia

4- cleft lip& palate

5 : classII restoration.

6 :classI restoration.

also, last molar shows classI amalgam restoration.

-pt have done restorative treatment on lower 6 class I ,

7 class I last molar class I amalgam restorations

- Endo ttt 5

during first visit the pt take impressionsfor study models, bite registration&face bow transfere, as well as photographes

lower class II modi 2

mouth preparation:

4 : endodontic treatment + selective grinding

intraradicular attachment { post & metal coping as core }

we will evalute the state of restoration & if there any defective restoration retreatment is must.

7 : full coverage + ring clasp .

5: retreatment for endo +intraradicular attachment {post+metal coping}.

6 : full coverage + RPI

major connector:

Impression:

- lingual bar :away from gingival margin 3 mm

when at least 8 mm space

- lingual plate: better support splinting & act as indirect retainer.

selection of abutment in over denture

upper class II modi 3

1ry: alginate .

2ry: alginate ,

rubber base{putty} better in under cut

Dnture base:

impression:

combined denture base

mouth preparation:

metal housing in denture base

impression technique:

like upper in 1ry & 2ry except in 2ry take in our consideration that we will make intraradicular attachment in 4&5 so, we put plastic post & duralay and make over all impression with rubber base.

functional impression technique

occlusion & jaw relation ?

Idealy: bilateral, symmetrical with minimum of one tooth space between them.

- healthy attached gingiva.

- adequate periodontal support.

- No or limited mobility

impression are recorded under functional load, it record tissue in acompressed form(under bitting force)

also, known as mucocompresive technique or close mouth impression technique.

Relation between upper and lower arch

alternative ttt :

3 : extra coronal attachment {ball&socket} rested on

crown in mesial side .

5 : endodontic treatment + metal coping

3 : Extraction

4 : extra coronal attachment {ball& socket} mesially + distal rest also this design prepared on crown

last molar: aker clasp with mesial rest .

advantage:

flexable partial denture

sohaib ambon

patient can exert his own masticatory force on impression material.

mona zarif

yasmeen hosny

yasmin mohamed

mona abu el maaty

after we make study cast we must survay the cast to adjust the path of insertion & under cuts

Denture base:

sometimes being understanding is more important than being right .

combined denture base {vitalium frame work covered with acrylic }.

advantage:

future relining.

attachment { female "socket"} on fitting surface of denture base & metal housing for coping

Major connector :

{antroposterior palatal strap}

but if there is mobility or periodontally affected teeth {palatal plate}

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